Recommendations on how to provide cardiac rehabilitation services during the COVID-19 pandemic

Kemps, Hareld; Brouwers, R. W. M.; Cramer, Maarten J.; Jørstad, Harald T; Kluiver, Ed P de; Kraaijenhagen, R. A.; Kuijpers, Petra; Linde, M. R. van der; Melker, E. de; Salgado, Rodrigo; Spee, Ruud F.; Sunamura, Madoka; Vromen, Tom; Wittekoek, M. E.

doi:10.1007/s12471-020-01474-2

Cited by 26 publications

(27 citation statements)

References 5 publications

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“…Furthermore, telerehabilitation can be offered relatively simply and affordably to a large, heterogeneous group using video or telephone consultations, text messaging and social media [ 18 ]. It has, therefore, been suggested that the availability of cardiac telerehabilitation should be upscaled during the current COVID-19 pandemic and that these (online) services also be made (freely) available to chronic CVD patients [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 lockdown on physical activity and sedentary behaviour in Dutch cardiovascular disease patients

Bakel¹,

Bakker

Vries³

et al. 2021

Neth Heart J

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Background Coronavirus disease 2019 (COVID-19) lockdown restrictions may impact lifestyle and therefore also physical (in)activity patterns in patients with cardiovascular disease (CVD). This study aimed to evaluate the effect of lockdown on physical activity and sedentary behaviour. Methods A total of 1565 Dutch CVD patients participated in this prospective cohort study, in which we compared physical activity and sedentary behaviour before and during the COVID-19 lockdown period. Baseline measures were assessed in 2018 and data on follow-up measures were collected between 17 and 24 April 2020 (5 weeks after the introduction of COVID-19 lockdown restrictions). Validated questionnaires were used to assess physical activity and sedentary behaviour. Results Moderate-to-vigorous physical activities increased from 1.6 (0.9, 2.8) to 2.0 (1.0, 3.5) h/day [median (interquartile range)] (p < 0.001) during the COVID-19 lockdown, mainly due to an increase in time spent walking and doing odd jobs. In contrast, time spent exercising significantly declined [1.0 (0.0, 2.3) to 0.0 (0.0, 0.6) h/week], whereas sedentary time increased from 7.8 (6.1, 10.4) to 8.9 (6.8, 11.4) h/day (p < 0.001). The absolute increase in physical activity was 13 (−36, 81) min/day, whereas sedentary behaviour increased by 55 (−72, 186) min/day. Conclusion Despite a small increase in physical activities, the larger increase in sedentary time induced a net reduction in habitual physical activity levels in Dutch CVD patients during the first-wave COVID-19 lockdown. Since a more inactive lifestyle is strongly associated with disease progression and mortality, we encourage CVD patients and their caregivers to explore novel solutions to increase physical activity levels and reduce sedentary time during (and beyond) the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 lockdown on physical activity and sedentary behaviour in Dutch cardiovascular disease patients

Bakel¹,

Bakker

Vries³

et al. 2021

Neth Heart J

View full text Add to dashboard Cite

show abstract

“…As of early 2020, delivery and introduction of many direct face-to-face health services have been stymied by the COVID-19 pandemic across the UK [9][10][11] and other afflicted nations [12][13][14][15] which has caused many providers to seek alternative modes of service delivery. This is an appropriate initial response as the risks from contracting COVID-19 to cancer populations are higher than in the general population, principally due to advanced age and the presence of comorbidities [16].…”

Section: Introductionmentioning

confidence: 99%

Remote interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review and meta-analysis

et al. 2021

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Background The COVID-19 pandemic has forced many cancer services to consider a transition to a remote format of delivery that is largely untested. Accordingly, we sought to perform a systematic review of the effects of remotely delivered interventions to improve exercise behaviour in sedentary adults living with and beyond cancer. Methods Eligible studies were randomised controlled trials comparing a remotely delivered exercise intervention to a usual care comparison in sedentary people over 18 years old with a primary cancer diagnosis. Nine electronic databases were searched from inception to November 2020. Results The review included three trials, totalling 186 participants. Two of the included trials incorporated prescriptions that meet current aerobic exercise recommendations, one of which also meets the guidelines for resistance exercise. No trials reported an intervention adherence of 75% or more for a set prescription that meets current exercise guidelines. Conclusion There is little evidence suggesting that remote exercise interventions promote exercise behaviours or improve physical function in sedentary adults living with and beyond cancer. The development and evaluation of novel remote exercise interventions is needed to establish their usefulness for clinical practice. Given the social response to the COVID-19 pandemic, further research in this area is urgently needed.

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“…Currently, a system to provide phase 2 CR during the COVID-19 pandemic is under consideration [ 2 , 3 ]. The present study suggested that more careful intervention is needed with a focus on the decline of physical function, especially in patients aged 75 years and older.…”

Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may increase mortality in affected patients with cardiovascular disease (CVD) [ 1 ]. In addition, because it spreads from person to person via close contact, the delivery of cardiac rehabilitation (CR) is currently being hampered in many countries due to the COVID-19 pandemic [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on phase 2 cardiac rehabilitation patients in Japan

et al. 2021

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This study aimed to clarify the effects of the interruption of cardiac rehabilitation (CR) and refraining from going outside due to the COVID-19 pandemic on hemodynamic response and rating of perceived exertion (RPE) during exercise including differences by age in phase 2 CR outpatients. Among 76 outpatients participating in consecutive phase 2 CR in both periods from March to April and June to July 2020, which were before and after CR interruption, respectively, at Sanda City Hospital were enrolled. The inclusion criterion was outpatients whose CR was interrupted due to COVID-19. We compared the data of hemodynamic response and RPE during exercise on the last day before interruption and the first day after interruption when aerobic exercise was performed at the same exercise intensity in the < 75 years group and ≥ 75 years group. Fiftythree patients were enrolled in the final analysis. Post-CR interruption, peak heart rate increased significantly (p = 0.009) in the < 75 years group, whereas in the ≥ 75 years group, weight and body mass index decreased significantly (p = 0.009, 0.011, respectively) and Borg scale scores for both dyspnea and lower extremities fatigue worsened significantly (both, p < 0.001). CR interruption and refraining from going outside due to the COVID-19 pandemic affected the hemodynamic response, RPE during exercise and body weight in phase 2 CR outpatients. In particular, patients aged ≥ 75 years appeared to be placed at an increased risk of frailty.

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Recommendations on how to provide cardiac rehabilitation services during the COVID-19 pandemic

Cited by 26 publications

References 5 publications

Impact of COVID-19 lockdown on physical activity and sedentary behaviour in Dutch cardiovascular disease patients

Impact of COVID-19 lockdown on physical activity and sedentary behaviour in Dutch cardiovascular disease patients

Remote interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review and meta-analysis

Impact of the COVID-19 pandemic on phase 2 cardiac rehabilitation patients in Japan

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